Abstract
Abstract Background: Myocardial revascularization surgery (MRS) is the most frequently performed cardiac surgery in Brazil. However, data on mortality rates among patients undergoing MRS in hospitals other than the main referral centers in the northern Brazil are scarce. Objective: To describe the clinical course of patients that submitted to MRS in the major public cardiology referral hospital in the Brazilian Amazon. Methods: Retrospective cohort analysis, by review of medical records of patients who had undergone MRS at Hospital das Clinicas Gaspar Vianna (FHCGV) from January 2013 to June 2014. Results: A total of 179 patients were evaluated. Mortality rate was 11.7% until 30 days after surgery. Waiting time for surgery ≥ 30 days (OR 2.59, 95%CI 1.02 - 6.56, p = 0.039), infection during hospitalization (OR 3.28, 95%CI 1.15 - 9.39, p = 0.021) and need for hemodialysis after surgery (OR 9.06 95%CI 2.07 - 39.54, p = 0.001) were predictors of mortality after CABG. Conclusion: A high mortality rate in the study population was found, higher than that reported in the literature and in other regions of Brazil.
Highlights
Ischemic heart disease is the main cause of death and work disability, causing high costs in public health and socio-economic impact in Western countries.[1]
Despite historical advances in clinical therapy and percutaneous intervention in terms of technique and materials, results of multicenter studies have shown that Myocardial revascularization surgery (MRS) is superior to both percutaneous coronary intervention (PCI) and clinical treatment alone in reduction of major cardiovascular events in specific groups of patients, such as diabetics, patients with multiple vessel disease or complex coronary artery disease (CAD) involving left coronary trunk.[5,7,8,9,10]
The aim of this study was to describe the clinical course of patients undergoing MRS at the largest, referral public cardiology center in the Brazilian Amazon
Summary
Ischemic heart disease is the main cause of death and work disability, causing high costs in public health and socio-economic impact in Western countries.[1] In Brazil, coronary artery disease (CAD) accounted for approximately 250 thousand hospitalizations and 16 thousand deaths in 2015. Management of ischemic heart disease is complex and encompasses the control of risk factors and symptoms, aiming at reducing morbidity and mortality and optimizing patients’ quality of life by means of optimized clinical therapy associated or not with revascularization procedures – percutaneous coronary intervention (PCI) or myocardial revascularization surgery (MRS).[3,4,5,6]. MRS is the most performed cardiac surgery in Brazil, approximately 80% of them in public health centers. Conclusion: A high mortality rate in the study population was found, higher than that reported in the literature and in other regions of Brazil. (Int J Cardiovasc Sci. 2019;32(3)217-226) Keywords: Myocardial Revascularization/mortality; Hospitals, Public; Epidemiology; Postoperative Complications
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